Early Childhood Inclusion - Association of University …€¦ · · 2017-03-30Early Childhood Inclusion: ... becomes most apparent during this developmental period. Study Population.

Early Childhood Inclusion: Peer Competence as a Core Element

Michael J. Guralnick, Ph.D.Director, Center on Human Development

and DisabilityProfessor of Psychology and Pediatrics

University of Washington Seattle, Washington USA

Access – universal access to inclusive programs

Accommodations – adjustments that maintain integrity of program model

Developmental Progress – at minimum, equivalent social and cognitive competencies in inclusive settings compared to specialized settings

Social Integration – meaningful social participation between children with and without disabilities; sense of belonging

Goals for Preschool Inclusion

(Guralnick, 2001; Guralnick & Bruder, 2016)

Inclusive Goals Tied to Peer Competence

Social Competence

Peer-Related Social Competence

Peer Relationships and Friendships

Developmental Progress and Social Integration

Peer Relationships and Friendships

Features• Characterized by more balanced exchanges• Relationships with peers are often

unpredictable and unforgiving• Peer system easily perturbed by

environmental or biological factors

Building relationships is core component of child development—including relationships with peers


Fundamental Issue in Our Field

Functions of Peer Relationships• Carry implications for cognitive, communicative,

emotion-regulation, and prosocial domains of development (developmental progress)

• Essential element in social integrationat all levels

• Key to independence and self-determination

• Inclusion must be a core component of all early intervention programs

• Enhancing peer competence must be a goal and high priority in the context of early intervention programs

• Critical to consider the broad developmental influences on peer competence, including family patterns of interaction

Three Key Points

Definition: Use of appropriate and effective social strategies in carrying out one’s interpersonal goals in the peer context



Social Strategies Within Social Tasks

• Peer group entry• Conflict resolution• Maintaining play

Building Peer Relationships

Peer Context: Goals as Social Tasks

Research Program

• Peer system of 3 to 6 year old children with mild (cognitive) delays

• Begin to see emergence of various complex forms of peer interactions

• Evidence of problems and their nature becomes most apparent during this developmental period

Study Population

Sources of Information

Findings- Consistent patterns suggesting existence of

major and pervasive peer-competence difficulties for young children with mild intellectual delays

- Significant implications for the inclusion goals of developmental progress and social integration

• Observational measures• Parent reports• Teacher reports• Children’s reports

Dimensions of quality and quantity of social interactions with peers to index peer competence

• Free-play settings: window to interpersonal expression- Group (sustained interactive play)- Positive / negative exchanges- Communication: compromise/negotiate

Observational Measures of Peer Social Competence: Profile

• Transition• Conversation• Rough & Tumble• Exploratory• Adult Involved

Social Participation Scale• Solitary• Parallel• Group• Unoccupied• Onlooker• Reading

Cognitive Play• Functional• Constructive• Dramatic• Games

• Attention *• Resource *• Lead - Positive *• Lead - Negative *• Follow Activity• Imitate • Affection• Hostility

Individual Social Behavior Scale

* Successful or unsuccessful

• Compete - Adult *

• Compete - Equipment *

• Pride Product

• Follow Lead

• Refuse/Ignore

• Modeling

• Structural- MLU- no. complex utterances

• Functional- behavior requests- information statements- information requests

• Discourse and Speech Style- attentionals- exemplification & demonstration- mitigated directives- permission requests- agreement/disagreement

Communicative Measures

Conditions• Cross-sectional• Moderate-mild delay• Community preschool (specialized)

Concerns

(Developmental Psychology, 1984)

10

25

5

15

30-41 42-53Chronological Age Range (months)

20End of Year

54-65 66-77

Beginning of Year

Tota

l Soc

ially

D

irect

ed B

ehav

ior

Findings• Absence of change over time (30-77 months)• Dominance of two-unit exchanges• Fragility after summer hiatus—lower level at beginning of each year• Small percentage dominated group play

Conditions• Longitudinal (2 year period): mild delay• Quartets with typically developing children

Problems Persist Over Time

(Child Development, 2006)

10

40

Chronological Age (mean months)

20

High initial levels

61 84

Low initial levels

Peer

Inte

ract

ion

Com

posi

te

30

Findings• No gains for high interactors• Low levels of group play overall

(8% at 84 months)• Negative and positive behaviors

highly correlated—conflicts• Minimal gain for low interactors

70

TypicallyDeveloping4-year-olds


MildlyDelayed

4-year-olds

Soci

al P

lay

Com

posi

te 60

50

40

30

20

10

0

Peer Competence Comparisons

250



MildlyDelayed

4-year-olds

Tota

l Pos

itive

Inte

ract

ions

200

150

100

50

0

Directiveness

18



MildlyDelayed

4-year-olds

Perc

ent G

roup

Pla

y

16

14

12

10

0

8

6

4

2

Dyadic Interactions

(Journal of Speech and Hearing Research,1989)

Prop

ortio

n of

Com

mun

icat

ions

In

volv

ing

a D

isag

reem

ent

.30

.20

.10

0

–Less mitigation of imperatives–More insist negatives as a strategy–High use of non-adaptive strategies



DevelopmentallyDelayed

4-year-olds

Conflicts

Unfamiliar Typically

Developing Peers

Peer

Inte

ract

ion

Com

posi

te 30

25

20

15

10

5

0

Constraints Imposed by Peer Competence

Friends: Primarily Typically

Developing

Correlations Between Settings

r = .60 compositer = .55 group play

(Journal of Applied Developmental Psychology, 2007)

Perc

ent Y

es

50

40

20

0

Peer Social Networks in the Community

Typically Developing4-6-year-olds

Developmentally Delayed4-6-year-olds

3

5

2

1

0

Rat

ing

Typically Developing4-6-year-olds

Developmentally Delayed4-6-year-olds

Frequency of Play with Peers in Community

1 = less than one/month5 = 4 or more times/week

30

10

4

Met in preschool / daycare

In same preschool / daycare

Linkage

(American Journal on Mental Deficiency,1997)

Community: 14% identify best friend

Difficulty finding friend for playdates

Friendships

• Problems of peer competence extend beyond those expected based on developmental level

• Low levels of productive, especially group play• Lack of directiveness (organization)• Social goals (tasks) not well established• Conflicts are common; high correlation between positive

and negative interactions• Modest changes over time; fragile set of social skills

Peer-Related Social Competence: Summary

1970s Emerging recognition of problem

• Peers as agents of change (reinforcement and modeling)

• Application of reinforcement strategies and environmental manipulations for individual children

1980s

1990s

2000-present

Behavioral Interventions• Translation of contemporary

models to intervention programs

• Understanding of social competence and family-peer linkages: Emergence of models

• Recognition of magnitude and pervasiveness of problem

• Inclusion as intervention

(Guralnick, 2010)

Family Patterns of Interaction

Child Social and Cognitive Competence

(Guralnick, 2011)

Discourse frameworkInstructional partnershipSocioemotionalconnectedness

Parent’s social networkPeer networkStimulating environmentChild care (Inclusive)Community activitiesPreschool program (Inclusive)Focus on special interests and needs

Protection from violencePreventative healthEnvironmental hazards

Health and Safety Provided by Family

Parent-Child Transactions

Family Orchestrated Child Experiences

Family Resources

Mental and physical healthIntellectual abilityAttitudes and cognitive readiness

Coping stylePerceived confidence and competence

Financial resourcesSocial support

Material ResourcesPersonal Characteristics of Parents

Organizational ProcessesDevelopmental Resources

CognitionLanguageMotorSocial-emotionalSensory-perceptual

Executive functionMetacognitionSocial cognitionMotivation Emotion regulation

Peer Competence

Family-Peer Linkages

Developmental Systems

Approach



(Guralnick, 2011)







Family Resources








Peer Competence


Developmental Systems

Approach



(Guralnick, 2005, 2012, 2013, 2016)







Family Resources








Peer Competence

DevelopmentalMechanisms


What Can the Early Intervention Team and Families Do to Promote Peer Competence?

Evidence for:• Finding and supporting an inclusive preschool• Arranging, monitoring, and facilitating peer

play at home (peer networks)• Strengthening “horizontal” parent-child

interaction patterns (parent-child transactions)

Developmental Systems Framework

Inclusive Preschool: Promoting peer social networks and peer competence at school

Promoting peer networks: arranging, monitoring, and facilitating peer play at home and community


Peer Competence

Social Strategies

Family Factors

Promoting parent-child transactions

Peer-Competence Mechanisms

Outcomes

Motivation● ● ●

Emotionregulation● ● ●

Social cognition● ● ●

Executive function

Language● ● ●

Cognition






Executive function

Peer Competence

Social Strategies

Family Factors Peer-Competence Mechanisms

Outcomes



Language● ● ●

Cognition

Conditions• Majority of children were TD and similar CAs• Within subject design (matched on other programmatic factors such as teacher-child ratio and

number of children)

Effects of Inclusion

60

Inclusive Specialized

Tota

l Pos

itive

Inte

ract

ions

D

D C

hild

ren 50

30

20

0

40

Findings• Inclusion had major impact on overall positive interactions with peers• Suggest value of majority of TD peers and potential influences related to modeling and demand

characteristics

Minimal Influence on Social Strategies or Mechanisms







Executive function

Peer Competence

Social Strategies

Family Factors Peer-Competence Mechanisms

Outcomes


Language● ● ●

Cognition

• Arranging playdates• Potential for promoting peer competence

High

Low

Medium

1 2

Extent of Maternal Arranging (rate per week)

Children with developmental delays

4 5

Children with Down syndrome

Invo

lvem

ent w

ith P

eers

(num

ber a

nd fr

eque

ncy

of p

laym

ates

)

Family Influences on Peer Interactions

3

(r=.50)

(r=.43)

(Journal of Intellectual Disability Research, 2002)







Executive function

Peer Competence

Social Strategies

Family Factors


Peer-Competence Mechanisms

Outcomes

Language● ● ●

Cognition

Family Influences on Peer CompetencePe

er C

ompe

tenc

e(c

ompo

site

)

• Mother-child play interaction• Importance of horizontal (mutual) vs vertical exchanges

Children’s Influence Attempts with Mothers During Play (Frequency) (Requests, Directives, and Mother Compliance)

• Controlling for child characteristics and mother arranging

• Predicts peer competence two years later• Suggests a new intervention approach

(Child Development,2007;Journal of Applied Developmental Psychology, 2007)

Features of the First Comprehensive, Randomized, Prospective, Controlled Design

• Developmental systems approach framework to guide early intervention

• Longer-term intervention (2 years)

• Children in inclusive settings

• Highly individualized (Assessment of Peer Relations; Family Assessment)

• Comprehensive – consultant model involving teachers and mothers (partnerships)

Contemporary Models

Assessment of Peer RelationsSocial Strategies

A. Peer Group EntryStrategies• initial attempt• second efforts

B. Conflict ResolutionStrategies• conciliatory/agreeable• negative/disconnected

C. Maintaining PlayStrategies• role and activity structure• management

Social ProcessesA. Shared UnderstandingB. Emotion RegulationC. Social-CognitiveD. Higher-Order

Clinical Tools

Intervention Framework• Promote effective and appropriate use of social

strategies within social tasks

• For mothers: address playdates, monitoring and facilitating dyadic play, improve social support, control issues, and promote horizontal interactions

• Frequent use of role playing relying on scripts, both mothers and teachers

• Guidance in script development based on mechanisms identified on APR: A social task context

• Assume structure within each social task• Remembering and acting upon event sequences• Critical events have nodes (variations around nodes)• Teach scripts for the three social tasks; repetition and variation are keys• Content of scripts:

- goal of social task- a cue to evoke the goal- strategies toward goal - successful resolution of task

• Attempt addresses issue of generalization: teach scripts in context of play

Scripts

NodesMaintaining Play Script Icons

Goal: Stay Together

4

1

65

2 3

Engaged Disengagement Strategy

Stay TogetherSecond effortFailure

Building the Script• Follow nodal structure• Practice at school and home • Always worry about Social Task Recognition

(higher - order); Executive function–emphasize cues that one is involved in a social task –emphasize goal (join, happy, stay together)

Mechanisms to be addressed incorporate fictional characters

Mechanisms to be addressed incorporate fictional characters

Mechanisms: Organizational Processes

Executive Function

SocialCognition

EmotionRegulation

Motivation

• Not just teach strategy • Not teach mechanisms independent of social task

(e.g., strengthen emotion regulation)• Address process as part of fictional characters representing mechanisms of

interest in context of a social task• Examples:

1. child fails to persist (executive function / motivation) – choose character who tries again and again

2. child easily upset (emotion regulation) – choose character who exhibits even or consistent mood

3. child fails to encode cues accurately (social-cognitive) – choose character who is attentive to cues

Use of Fictional Characters:Mechanisms

Frame of ReferenceEncode

Target Child Other Children1

3 4

2

Peer Entry Task

75M

ean

Scor

e

70

65

60

55

45

ControlCA (months) 64.17InterventionCA (months) 63.57

Full Scale IQ (WPPSI-R)

VABS Adaptive Behavior Composite

CBCL Total Behavior Problems

Family SES

50

N=90Pre-test

• Focus on generalization• Three typically developing children (slightly familiar

with one another) – entry task• Same CA and gender as target child• Quartets played for three consecutive days (1 hr/day)

Evaluation Setting

Prop

ortio

n C

hang

ePr

e-Te

st to

Pos

t-Tes

t.6

.4

.2

0

-.2

-.4

-.6

ControlIntervention

Non-Responsive to Peer Positive

Responsive to Peer Positive -

Proportion

Total Negative Behavior

Panel A (IQ < 70) Panel B

Parallel-DramaticPlay

(American Journal on Mental Retardation, 2006)

• Major improvement in peer competence not found• Encouraging—bar set high for generalization

(unfamiliar peers in unfamiliar settings)• Preventing peer interaction problems

Summary of Research Findings

• Peer competence is critical to goals of inclusive practice• Relevant to developmental progress and social integration• Inclusion is a critical component of early intervention

programs needed to support children’s peer competence• Promoting peer competence requires an understanding of

family-peer linkages within a developmental framework• Peer competence is strongly associated with long-term

independence and quality of life• Future research and practice must take a systems-level

approach and directly target peer competence

Conclusions

Early Childhood Inclusion - Association of University …€¦ · · 2017-03-30Early Childhood Inclusion: ... becomes most apparent during this developmental period. Study Population.

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